Khalil, N. S., M. S. Ismaee, A. H. Askar, and M. S. Sayed, Effects of manual hyperinflation with rib cage compression and endotracheal suctioning on arterial blood gas parameters in mechanically ventilated patients at a university hospital, Egypt, , vol. 15, 2021/11/12. Abstract

AbstractBackground: Manual hyperinflation and expiratory rib cage compression are methods of chest physiotherapy. They
are commonly applied but their value and their early utilization managing mechanically ventilated remain questionable.
The purpose of the study was to investigate the effects of manual hyperinflation with rib cage compression and
endotracheal suctioning on arterial blood gas parameters in mechanically ventilated patients.
Results: Seventy mechanically ventilated patients at a teaching hospital in Egypt were assigned to the clinical trial
study. The age of more than half of the studied samples ranged between 60 and 69 years with a mean age of 53.64 ±
16.44 years. Initially, the ABG parameters were assessed. Then, the patients were exposed to manual hyperinflation for
5 min and 20 min external expiratory chest compression followed by endotracheal suctioning. Later, ABG parameters
were assessed again and compared to the initial one. The findings revealed significant differences in ABG parameters
before and after completion of MHI and ERCC and ETT suctioning in relation to PaO2
(t = 3.892) and SaO2
(t= 5.904).
Also, it showed significant improvement in PaO2
and SaO2
after the completion of interventions, while no significant
differences were found in other ABG parameters. This study was registered retrospectively with an ISRCTN number
39983 on 5/6/2021.
Conclusion: Applying manual hyperinflation with rib cage compression and endotracheal suctioning improved
mainly the arterial oxygenation parameters in mechanically ventilated patients despite no significant changes
observed in other ABG parameters.

Badr, M. N., N. S. Khalil, and A. M. Mukhtar, "Effect of National Early Warning Scoring System Implementation on Cardiopulmonary Arrest, Unplanned ICU Admission, Emergency Surgery, and Acute Kidney Injury in an Emergency Hospital, Egypt.", Journal of multidisciplinary healthcare, vol. 14, pp. 1431-1442, 2021. Abstract

PURPOSE: To evaluate the effect of national early warning scoring system (NEWS) implementation in identifying patients at risk of clinical deterioration at an emergency hospital.

BACKGROUND: Early warning score has been developed to facilitate early detection of deterioration by categorizing a patients' severity of illness and prompting nursing staff to request a medical review at specific trigger points.

PATIENTS AND METHODS: A prospective, control/intervention groups', quasi-experimental design was utilized. A sample of 364 adult patients were admitted to the inpatient unit at an emergency hospital for six months. The patients were divided into a study group (174 patients) and a control group (190 patients). All study patients were followed up to either death or hospital discharge before and after implementing a new observation chart. The patients' outcomes were compared and analyzed between both groups.

RESULTS: In the intervention period, compared to the control period, a significant reduction was seen in the number of cardiopulmonary arrest (4.7% vs 1.1%, p = 0.046), unplanned ICU admission (5.3% vs 1.7%, p = 0.049), emergency surgery (6.3% vs 0%, p = 0.001), acute kidney injury (6.8% vs 1.1%, p = 0.006). As well, there was a significant increase in the number of patients receiving medical reviews following clinical deterioration in terms of escalation plan (3.2% vs 26.4%, p = <0.001).

CONCLUSION: The implementation of NEWS was associated with a significant improvement in patients' outcomes in hospital wards, increases in the frequency of vital signs measurements, and an increase in the number of medical reviews following clinical instability.

Khalil1, N. S., M. S. Ismaeel, and A. S. Ewees, "Thrombolytic therapy in acute MI: coronary care nurses’ knowledge and practice", British Journal of Cardiac Nursing, vol. 13, issue 7, pp. 2-9, 2018.

Assist professor

Khalil1, N. S., "Critical care nurses' use of non-pharmacological pain management methods in Egypt", applied nursing research, vol. 44, pp. 33-38, 2018.
Khalil1, N. S., 2 Manal Sayed Ismaeel1, 3 Sherine Ali Hassan1, and H. shawky4, "Effects of lavender oil inhalation on sternotomy related pain intensity in open heart surgery patients in Egypt", clinical practice, vol. 16, issue 1, pp. 1005-1010, 2018.
Khalil1, N. S., M. S. Ismaeel, and G. A. N. Mohamed3, "Identification of the risk factors and microbes responsible for inducing central line blood stream infection at a ministry of health hospital in Egypt", clinical practice, vol. 15, issue 4, pp. 755-763, 2018.
Khalil1, N. S., M. F. Mostafa2, and N. Y. Ahmed2, "Sleep quality among patients with chronic obstructive pulmonary disease at a university hospital in Egypt", clinical practice, vol. 16, issue 2, pp. 1085-1092, 2018.